Comparative Study of the Use of EPSDT and Other Preventive and Curative HealthCare Services by Children Enrolled in Medicaid: Final Project Synthesis Report

摘要

The report synthesizes the findings presented in other contract reports. Itincludes a description of the Medicaid program in MI, GA, TN and CA and the states' responses to the OBRA-89 provisions relating to children's Medicaid coverage and on the EPSDT program; results of analyses of the impact of these responses on participating providers and enrolled children, then put into a national context by reviewing the results of the national survey data analyses. State efforts to increase provider participation in Medicaid and EPSDT included recruitment activities, burden, training in billing and increased fees. The State's efforts were successful in increasing provider participation and average caseloads among all types of providers, except among dentists in Michigan, which declined 10 percent from 1989 to 1992. However, the increases may not have been adequate to meet the increased demand from the increased number of children enrolled in Medicaid. The ratios of the numbers of child Medicaid enrollees to participating physicians and dentists serving children and the percentage of counties with shortages of child health physicians rose from 1989 to 1992 in all four study States. No marked shift to office-based physicians occurred; institutional providers remained an important source of health care in general and preventive care in particular for Medicaid children in 1992.